Source:
https://scmp.com/comment/insight-opinion/article/2144416/patients-and-guardians-need-be-kept-fully-informed-about
Opinion/ Comment

Patients and guardians need to be kept fully informed about procedures

Case of 16-year-old girl left partially paralysed after operation at United Christian Hospital shows need for families to be aware of risks, however small

A photo of the girl in the United Christian Hospital incident. Photo: Felix Wong

Fixing responsibility and compensation for medical incidents and blunders that cause serious harm or loss of life may bring closure of a kind to victims and families.

But where peer review of an incident finds that treatment with a tragic outcome was nonetheless appropriate and not medical negligence, it can be hard to come to terms with the reality of the risks associated with any invasive procedure.

Such is the plight of a 16-year-old girl and her family after an incident at United Christian Hospital left her partially paralysed. One reason for their feelings is that doctors did not inform them of the risk of the complication that arose, even though it was very low.

That oversight has done nothing to convince the family that the incident did not involve medical errors or that the hospital should not admit liability.

United Christian Hospital in Kwun Tong. Photo: Felix Wong
United Christian Hospital in Kwun Tong. Photo: Felix Wong

After seeking help last October for head and neck pain and right-side weakness, the Form Four pupil was found to have acute transverse myelitis, or inflammation of the spinal chord.

After steroids failed to help, doctors recommended plasmapheresis, or replacing the patient’s blood plasma with that of a donor or from a substitute.

During the procedure, the girl developed serious complications after a paediatric intensive care doctor inserted a catheter into a vein in her neck for the transfusion. Doctors found the girl’s subclavian artery to be damaged.

But Dr Alan So King-woon, of the Hospital Authority’s central coordinating committee on paediatrics, said there was no evidence the damage was caused by human error while inserting the catheter.

He suspected it was damaged accidentally when a catheter guide wire was inserted. He conceded the family should have been told of the risks.

The girl’s mother says her daughter cannot now eat unassisted or even swallow water.

Patients wait in the accident and emergency room at the United Christian Hospital. Photo: David Wong
Patients wait in the accident and emergency room at the United Christian Hospital. Photo: David Wong

On the face of it, the investigation and denial of a blunder without a clear explanation of what went wrong leaves unanswered questions. United Christian Hospital has offered an apology and sympathies, but the family says there has been no face-to-face apology amid many remaining “doubts”.

The investigation aside, there may be an argument for a review to ensure properly informed consent so families are better prepared for all outcomes.

After all, at 16, the girl was entitled to a say on the risks.